Cisapride works by stimulating receptors in the nervous system associated with the digestive system. It promotes the release of the neurotransmitter acetylcholine while stimulating the motility of the upper part of the digestive tract without stimulating gastric, biliary or pancreatic duct secretions. The result is increased emptying of the stomach and intestinal transit.
What is Cisapride?
Cisapride is used to treat gastric reflux symptoms especially when it is associated with nocturnal heartburn resistant to other treatments.
When should Cisapride be taken?
Cisapride is administered orally in the form of tablets or liquid solution. Usually, 4 doses per day are taken, around 15 minutes before meals and at bedtime.
Side effects associated with Cisapride
Cisapride has been associated with serious side effects, sometimes cardiac and fatal. In particular, the drug can cause:
- Arrhythmias, especially in the presence of prior predisposing disorders, such as ventricular arrhythmias, renal failure, congestive heart failure, prolonged QT prolongation, ischemic heart disease, respiratory failure and uncorrected electrolyte imbalance
- Ventricular fibrillation
- QT prolongation
- Tachycardia
- Torsades de pointes
The risks are higher for individuals taking other drugs that may prolong the QT interval, inhibit cytochrome P450 or reduce serum electrolytes.
It is important to contact a doctor immediately if the intake of Cisapride is associated with chest pain or vision problems.
The other possible side effects of the active ingredient include the following:
- Constipation
- Diarrhea
- Headache
- Stuffy nose
- Stomach problems
- Cough
Contraindications and warnings associated with the use of Cisapride
On 14 July 2000, the manufacturer voluntarily withdrew from the US Food and Drug Administration due to Cisapride’s severe side effects. In Europe, the marketing of the active ingredient was suspended in Germany and the United Kingdom; the Pharmacovigilance and Drug Information Department of Ministry of Health had restricted the indications for its use in cases of gastroparesis in adults and gastroesophageal reflux disease in early childhood.
The drug can cause drowsiness so you need to be cautious and avoid taking it prior to driving or operating dangerous machinery. There are also concerns that alcohol can increase drowsiness induced by this active ingredient.
Before taking Cisapride, it is important to inform your doctor:
- If you are allergic to Cisapride or other drugs
- If you are taking any medicinal products or herbal supplements. You should mention in particular: anxiety drugs, anticholinergics, anticoagulants, diuretics, azithromycin, cimetidine, Dirithromycin, miconazole, tranquilizers, and vitamins
- If you suffer (or have suffered) from intestinal disorders or bleeding ulcers
- If you are pregnant or breastfeeding
